Patient Discomfort with Intra-arterial Iodinated Contrast Media
Author Information
Author(s): McCullough Peter A, Capasso Patrizio
Primary Institution: St. John Providence Health System, Department of Medicine, Cardiology Section, Providence Park Heart Institute, Novi, MI, USA
Hypothesis
Does the use of iso-osmolar contrast media (iodixanol) result in less patient discomfort compared to low-osmolar contrast media?
Conclusion
IOCM is associated with less frequent and severe patient discomfort during intra-arterial administration compared to LOCM.
Supporting Evidence
- 22 randomized controlled trials were analyzed with a total of 8087 patients.
- IOCM showed a significant reduction in discomfort compared to LOCM with a risk difference of -0.049.
- Patients reported less pain and warmth sensation with iodixanol compared to low-osmolar contrast media.
- Older age was associated with greater discomfort from pain but lesser discomfort from warmth.
Takeaway
Using a special type of dye for medical imaging causes less pain and discomfort for patients than other types of dye.
Methodology
A meta-analysis of 22 randomized controlled trials comparing discomfort rates between iodixanol and various low-osmolar contrast media.
Potential Biases
Some studies may have been biased towards the null hypothesis due to including trials with low symptom reporting.
Limitations
The study did not account for injection rates, bolus size, or the use of sedation, which could influence discomfort levels.
Participant Demographics
Average age was 62.5 years, with 29% female in the iodixanol group and 30.5% female in the LOCM group.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% CI: -0.265, -0.112
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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